Scaling the Project ECHO Model to Improve Sickle Cell Disease Management
Special Projects Fund
September 21, 2018
Project ECHO (Extension for Community Healthcare Outcomes) is an innovative model of health care education and delivery that can significantly improve the treatment of chronic and complex diseases for rural and underserved populations.
Unlike the typical telemedicine service model (directly linking providers and patients), the Project ECHO model uses Web-based videoconferencing to create virtual grand rounds through a central hub organization. This model dramatically increases access to specialty treatment in rural and underserved areas by providing front-line physicians with the knowledge and support they need to manage patients with complex conditions. NYHealth introduced this model to New York State in 2014 with a grant to establish the first Project ECHO clinic for geriatric mental health in primary care, in which primary care providers received telementoring from geriatric specialists. Initially, that program aimed to involve 75 participants in 8 counties; by the end of 2017, it had grown to 500 participants across 32 counties. Taking notice of this success, the New York State Department of Health (NYSDOH) also became interested in replicating and scaling the model—awarding $845,000 in 2017 to providers, including SUNY Upstate, to expand Project ECHO in health care settings in New York State. To further its investment in Project ECHO, as well as leverage the State’s investment, NYHealth awarded the Research Foundation for the State University of New York a grant in 2018 to expand SUNY Upstate’s existing ECHO clinic to include sickle cell disease management.
Under this grant, SUNY Upstate served as the hub site in Central New York, focusing on improving treatment and developing coordinated care plans for sickle cell patients in the region. Many providers lack knowledge about treating sickle cell patients and are often unwilling to take them on as patients, leaving sickle cell patients to seek out care and treatment in emergency rooms when they are in crisis. SUNY Upstate’s ECHO clinic is a unique collaboration between medical professionals and community-based providers—pulling together a multidisciplinary team of primary care providers, pharmacists, home care case managers, housing support, transportation support, social workers, pain management and addiction experts, and other outreach services. SUNY Upstate established monthly ECHO clinic sessions with the team to (1) offer educational presentations on sickle cell disease and treatment, (2) improve coordination of care and understanding of services offered among the providers, and (3) allow for case presentations and virtual grand rounds. To boost team recruitment and retention in the ECHO clinic, SUNY Upstate conducted robust marketing and outreach among care teams and emergency service providers at area hospitals and community-based providers and others who work with sickle cell patients.